Effectiveness of device-assisted ultrasound-guided steroid injection for treating plantar fasciitis

Am J Phys Med Rehabil. 2013 Jul;92(7):597-605. doi: 10.1097/PHM.0b013e318278a831.

Abstract

Objective: The aim of this study was to investigate the effectiveness of device-assisted ultrasound-guided steroid injection for treating plantar fasciitis.

Design: An ultrasound-guided injection device designed with space for securing a transducer and syringe was used to guide steroid injection. Patients with unilateral plantar fasciitis were enrolled and randomly divided into device-assisted ultrasound-guided and palpation-guided groups. Pain intensity was measured using a visual analog scale and tenderness threshold. Ultrasound and pain intensity evaluations were performed before injection and at 3 wks and at 3 mos postinjection. Betamethasone (7 mg) and 1% lidocaine (0.5 ml) were injected into the inflamed plantar fascia.

Results: Thirty-three patients who received either device-assisted ultrasound-guided or palpation-guided injection had significantly lower visual analog scale scores (P < 0.001) and higher tenderness threshold (P < 0.01) postinjection. However, the device-assisted group had higher tenderness threshold (9.02 ± 1.38 vs. 7.18 ± 2.11 kg/cm; P = 0.007), lower visual analog scale score (1.88 ± 2.13 vs. 3.63 ± 2.60; P = 0.046), and lower hypoechogenicity incidence in the plantar fascia (3/16 vs. 9/16; P = 0.033) than the palpation-guided group did at 3 mos postinjection. The heel pad was significantly thin (P = 0.004) in the palpation-guided group postinjection.

Conclusions: Device-assisted ultrasound-guided injection for treating plantar fasciitis results in better therapeutic outcomes than palpation-guided injection does.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cohort Studies
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Fasciitis, Plantar / diagnostic imaging*
  • Fasciitis, Plantar / drug therapy*
  • Female
  • Humans
  • Injections, Intralesional
  • Male
  • Middle Aged
  • Pain Measurement
  • Palpation / methods
  • Patient Positioning
  • Patient Satisfaction / statistics & numerical data
  • Risk Assessment
  • Severity of Illness Index
  • Steroids / administration & dosage*
  • Treatment Outcome
  • Ultrasonography, Interventional / instrumentation*

Substances

  • Steroids